Cognitive flexibility (CF) is an executive function component related to the ability to flexibly shift amongst multiple incompatible perspectives or descriptions of an object task. However, whether CF enhances the narrative discourse comprehension of students with attention-deficit hyperactivity disorder (ADHD) during surface semantic meaning identification remains unclear. This study aimed to examine the impacts of CF on central word (CW) identification amongst primary school students with ADHD and reading comprehension difficulties (i.e. scores in the ≤ 25th percentile of discourse comprehension but with adequate decoding skills and average decoding performance score within one standard deviation). In addition, the association of CF with CW identification performance, when the CW was located in either the first or second half of sentences, was tested with and without the interference of playing music. This study recruited 104 low-CF and 103 high-CF first grade students with ADHD and reading difficulties. Participants received measures of nonverbal intelligence, working memory, Chinese receptive vocabulary, Chinese word reading, CF and a music preference questionnaire. Additionally, participants completed the entire CW identification experiment (about 7 min) individually in a silent classroom located within the school campus. After controlling nonverbal intelligence, working memory, music preference, Chinese receptive vocabulary and Chinese word reading, the results showed that high-CF students had similar poetry discourse comprehension performance with low-CF students when the CWs were at the second half of a sentence. Moreover, high-CF students showed significantly better performance than low-CF students when the CWs were at the first half of the poetry sentences in both conditions with and without music, especially if the poetry sentence structure was more complicated than the typical ‘subject-verb-object’ sequence. All students with ADHD performed significantly worse in poetry discourse comprehension with music interference than without it. The results highlight the importance of CF in poetry discourse comprehension tasks, particularly when a poetry sentence uses a non-typical structure format. The possible effects of CF on poetry discourse comprehension are also discussed.

认知灵活性 (CF) 是一种执行功能组件，与在多个不兼容的观点或对象任务描述之间灵活转换的能力有关。然而，CF是否增强了注意缺陷多动障碍（ADHD）学生在表面语义识别过程中的叙事话语理解尚不清楚。本研究旨在检查 CF 对患有 ADHD 和阅读理解困难的小学生中心词 (CW) 识别的影响（即分数在话语理解的 ≤ 25%，但具有足够的解码技能和平均解码性能分数在一个标准内偏差）。此外，当 CW 位于句子的前半部分或后半部分时，CF 与 CW 识别性能的关联，在有和没有播放音乐的干扰下进行了测试。这项研究招募了 104 名低 CF 和 103 名高 CF 的一年级多动症和阅读困难学生。参与者接受了非语言智力、工作记忆、中文接受词汇、中文单词阅读、CF 和音乐偏好问卷的测量。此外，参与者在校园内的安静教室中单独完成了整个 CW 识别实验（约 7 分钟）。在控制非语言智力、工作记忆、音乐偏好、汉语接受词汇和汉语单词阅读后，结果表明，当 CWs 在句子的后半部分时，高 CF 学生与低 CF 学生的诗歌语篇理解表现相似。而且，当 CW 在有音乐和无音乐两种情况下都位于诗歌句子的前半部分时，高 CF 学生的表现明显优于低 CF 学生，尤其是当诗歌句子结构比典型的“主语-动词-”更复杂时对象的序列。所有患有多动症的学生在音乐干扰下的诗歌语篇理解能力都比没有音乐干扰时差得多。结果突出了 CF 在诗歌语篇理解任务中的重要性，尤其是当诗歌句子使用非典型结构格式时。还讨论了 CF 对诗歌语篇理解的可能影响。特别是如果诗歌句子结构比典型的“主语-动词-宾语”序列更复杂。所有患有多动症的学生在音乐干扰下的诗歌语篇理解能力都比没有音乐干扰时差得多。结果突出了 CF 在诗歌语篇理解任务中的重要性，尤其是当诗歌句子使用非典型结构格式时。还讨论了 CF 对诗歌语篇理解的可能影响。特别是如果诗歌句子结构比典型的“主语-动词-宾语”序列更复杂。所有患有多动症的学生在音乐干扰下的诗歌语篇理解能力都比没有音乐干扰时差得多。结果突出了 CF 在诗歌语篇理解任务中的重要性，尤其是当诗歌句子使用非典型结构格式时。还讨论了 CF 对诗歌语篇理解的可能影响。